Ok, we did talk a lot about hormones not in balance and periods not being regular. Someone who had studied biology in their higher secondary might comprehend this, but others are left without any clue. As such PCOS leaves us much confused, so I thought I’d write a post that is not actually a biology class but will throw some light on the hormones and their role in periods and what is wrong with us with PCOS.

I found these two images from internet which are by far the best depictions that I’ve seen. Thanks to the sites!!

  

The first pic shows how the hormones are responsible for having a regular cycle. It is interesting to note here that the Pituitary gland which is located near the brain is responsible for controlling all the hormones that make the ovaries function normally. Pituitary sends the LH and FSH (Luteinizing and Follicle stimulating Hormones) which determine the follicle formation and most important part Ovulation. After getting the signals from pituitary, the ovaries generate estrogen and progesterone. These are responsible for the uterus lining (endometrial thickness) and for menstruation when there is no fertilization of the egg.

The second pic shows the phases in the menstrual cycle and the normal hormone levels during each phase.

What happens to the hormones with PCOS?

In case of PCOS women, the LH is always higher than the normal levels. That means, even on the day one of the cycle, LH is higher than the FSH. As the LH levels are quite high, there is no LH surge meaning no ovulation. Thus the progesterone and estrogen (to be secreted by the follicle post ovulation – Corpus Luteum) levels also go out of balance and hence there is no periods for the cycle. The worst part in all this is that the follicle that failed to ovulate remains as the cyst and continues to produce more male hormone (androgen) causing all the unwanted hair and acne.

Another reason why the male hormone level goes up is the “Insulin Resistance” (this is going to be a separate post). Most of the PCOS women are insulin resistant which means, the level Insulin hormone secreted by Pancreas is high which causes the ovaries to make more testosterone.

I hope this post will be helpful in clarifying the hormones that your doc always keeps talking about at least to some extent. Do let me know if I have missed anything!

I think this post is going to be useful not just for women with PCOS but also for the mothers whose daughters are at the puberty stage. I am saying this because the symptoms start appearing in their mid teens and that is the best time to start treating this as it could be controlled way too effectively if it were to be treated at an early stage.

What are the changes that indicate PCOS?

• The first and the most visible – ACNE. Yes, most teenagers who have PCOS have bad cases of Acne which trust me, does not respond to anything on this earth :(  These acne outbreaks come without any regularity (I mean some girls get a pimple or two just before their monthly cycle – but the PCOS one gets them anytime).
• The second predominant symptom is the unwanted facial hair – again no permanent solution for this. Some people may also have hair growth in chest and stomach areas. Frustratingly accompanied with loss of hair in scalp.
• Abnormal weight gain or weight loss – That’s yet another strange thing about PCOS. Anything on the either side of normal signals PCOS.
• Irregular menstrual cycles – Again as is the case with PCOS, this might be lesser than 9 periods in a year with very less bleeding or more periods with very heavy bleeding.
• Mood swings – Mostly this is depression. This might be less noticeable in young girls but becomes a greater problem with women.
• In most cases, the syndrome is diagnosed only when there is a fertility issue. So I can also add Infertility or Fertility problems as one of the symptoms.

Is PCOS Hereditary?

Yes it is. Unlike one might think, one can get this syndrome if it ran in either of the parent’s family.  But that is just one thing. There are several other reasons why the hormone levels are not normal like environmental factors, dietary factors, etc. So if you have a doubt, start with checking if other women in the family have irregular periods, diabetes or fertility problems.

What are the diagnostics?

Be prepared to be embarrassed with questions and diagnostics when you go to a doctor for the first time for PCOS. I am sure none of us would ever forget our first visit and the questions that we had to answer for. But trust me, this will all sound just like regular discussion after a couple of visits to your doctor. So here’s what they ask/do:

1. Questions on hereditary factors like anyone else in family with PCOS and stuff
2. Questions on previous medical conditions and health in general
3. Physical examination of the body – to check for unwanted hair growth
4. Lot of blood work – to test for various hormone levels and to overrule other problems like thyroid/gland problems as they have similar symptoms.
5. In most cases, a scan or ultrasound which could be either pelvic or trans-vaginal. This not only confirms the PCOS but also helps the doc to make sure that you don't have any other major issues.

So what are the treatment?

The first thing that the doc would say if you are on the higher side of weight levels is to reduce the weight. Regular exercise and diet plans are the first step recommended (if ever you met a good doctor). Otherwise, the docs prescribe a medicine called Metformin – a  diabetes drug and birth control pills to regulate the periods or fertility medicine if you are trying to get pregnant. Some doctors suggest some kind of Acne soaps, astringents or creams for acne, but from my experience, they don’t work at all :(  So the best thing to do is stop being conscious and DO NOT pick the acne as they leave a scar which is again not easy to get rid of. For the unwanted facial hair, tweezing, threading or waxing are temporary solutions. I tried 4 sittings of laser and that didn’t work for me and am back to waxing now. Not sure how far permanent electrolysis is. But these are costly and painful alternatives.

As I had mentioned in about me, I was diagnosed with PCOS about 5 years ago and ever since that I have gathered much knowledge from my doctors, reading on PCOS and out of my own experience. I am going to share all those gyan here. In my initial posts, I am going to concentrate on preliminary info like understanding PCOS, its causes, symptoms and stuff like that. That's because, I believe that understanding the Syndrome (I’d rather not use the word “Disease” as it make it look sickening) is the first step towards fighting it. Yes, we have to fight the syndrome and keep it at bay as there is no permanent cure for this as far as I know. (Please correct me if I am wrong).

Ok, So what is PCOS?

PCOS is Poly Cystic Ovarian Syndrome (some call it PCOD which I don't want to). As the name states, you have multiple cysts in your ovaries when you have PCOS. But, there are also some cases where the Syndrome exists without multiple cysts. In either case, one has PCOS when the hormones in the woman’s body is out-of-balance. PCOS has become common these days (1 out of 15 women has PCOS). So you are not the only one crying “Why Me??” The symptoms in most cases are seen during the teen stage. Starting to attack PCOS at an early stage can go a long way to avoid future problems like the biggest one of them all – pregnancy problems and infertility.

What the heck are these Hormones?

Hormones are chemicals that are supposed to be present at certain levels for the body to run smoothly. Mostly one hormone is responsible for the generation of another. This make PCOS even more complex because if one is out of balance, it becomes redundant with all the other hormones. In general, the female ovaries generate a small amount of androgen (male sex hormone), but when one has PCOS, the ovaries generate an extra amount of androgen than what it should be. This causes anovulation (failure to ovulate), acne outbreak, growth of facial and unwanted hair (sometimes frustratingly with hair loss in the head). In most cases, this is coupled with Insulin resistance where the body refuses to assimilate the sugar content in the food. This raises blood sugar level and makes us more susceptible to diabetes in near future.
Next post topic: PCOS symptoms, causes, diagnostics and common treatment procedures

Hello and welcome. In this blog I am going to share my gyan on PCOS. I want to add this disclaimer that I am not a doctor.. well I aspire to be one someday :) but that is a different story altogether. But I will vouch that I will research thoroughly on all the things I say here before posting them. I’d love to hear what you have to say on the topics that I am going to be presenting here. Hope the facts here are helpful!